What do we know about brief interventions to increase physical - - PowerPoint PPT Presentation

What do we know about brief interventions to increase physical activity?

A systematic review of reviews

Laura Lamming Behavioural Science Group, The Primary Care Unit, University of Cambridge, UK. Dan Mason, Katie Morton, Sally Pears, Maaike Bijker, Stephen Sutton, Wendy Hardeman on behalf of the VBI Programme Team

1

Background

 Low levels of physical activity (PA) are associated with

significant disease burden (1)

 Primary care providers have access to large proportion of

public BUT have time constraints

 PA interventions may be easier to integrate into routine

primary care if they were brief

 Recent policy initiatives and guidance encourage use of brief

interventions

 But, NO agreed definition of a brief intervention 1 – Lee, I., Shiroma, E. J., et al. (2012). “Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.” The Lancet 380 (9838): 219-229.

2

Objectives

What do we know about brief interventions (BIs) to increase PA that could be delivered in a primary care setting?

 How are BIs defined?  Do BIs increase physical activity levels, and

compared to what?

 Which factors influence their effectiveness?  Who are they effective for?  Are they feasible and acceptable?

3

Standard systematic review methodology

Criteria

 PA interventions only  Systematic review/Meta-

analysis

 Adults, no PA

rehabilitation

 PA outcome  Individual level  Findings/Discussion of BIs

4

Descriptive data Narrative Synthesis

Data extraction

 Double checked

Results

Study selection

6

Records after duplicates removed N=5803 Records identified from ineligible comments: N=3 Excluded: N=5561 Excluded: N= 145 Excluded: N=88 Records identified from authors collection: N=4 For Title screening N=5803 For Abstract screening* N=242 For Full Text screening*: N=154 For Synthesis N= 10 Records identified from electronic databases: N=11993 Additional records identified: N=1

* Double screened

• 1. Definitions of brief interventions

 3/10 reviews gave definitions of BIs  Agreed that BIs, at their most minimal, could

include advice, verbal or otherwise, of a short duration

 One review specified a maximum duration (30

minutes), and two included interventions of up to 30 or 40 minutes

7

• 2. Effectiveness of brief interventions

 Reviews support the effectiveness of BIs on self-

reported physical activity in the short-term (6 weeks- 12 months)

 Lack of evidence/support for their effectiveness in

the long term and their impact on objectively measured physical activity

8

• 3. Factors that impact on the effectiveness
• f brief interventions

 Reviews support the use of high quality

supplementary written materials

 Lack of/inconclusive evidence for the impact

• f duration, type of provider, setting and

theoretical basis

9

• 4. Population characteristics

 Inconclusive and limited evidence for the

impact of targeting BIs at participants on the basis of various characteristics, e.g.:

– Age – Gender – Current activity level – Health status – Socio-economic status

10

• 5. Feasibility and acceptability of brief

interventions

Reviews report that the following factors can impact feasibility and acceptability of BIs for patients and practitioners:

 practitioner  patient  intervention content  structural factors (e.g. time constraints)

11

Key Conclusions

 2/3 of the reported definitions of BIs include interventions

too long for routine primary care consultations

 Future research should develop and evaluate very brief

interventions (VBIs) that could fit into a routine primary care consultation

 More evidence is needed about the long–term effectiveness

• f BIs for objectively measured and self-reported physical

activity

12

Thanks & Questions?

Special thanks: Isla Kuhn (Librarian) Sophie Attwood Author: ll356@medschl.cam.ac.uk VBI programme: VBI@medschl.cam.ac.uk VBI webpage: http://tiny.cc/VBIprog This presentation presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0608-10079). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

13